Healthcare Provider Details

I. General information

NPI: 1902859937
Provider Name (Legal Business Name): VESTAVIA HILLS IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 CANYON RD SUITE 25
VESTAVIA HILLS AL
35216-1903
US

IV. Provider business mailing address

2017 CANYON RD SUITE 25
VESTAVIA HILLS AL
35216-1903
US

V. Phone/Fax

Practice location:
  • Phone: 205-824-8262
  • Fax: 205-824-8264
Mailing address:
  • Phone: 205-824-8262
  • Fax: 205-824-8264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARGARITA L. TORRES
Title or Position: CREDENTIALING
Credential:
Phone: 504-459-3220